🔩Compliance & Audit
Audits are on the rise – but that doesn’t have to mean more stress! Fieldworker keeps your agency audit-ready
There are many requirements that each care agency needs to fulfill in order to ensure audits run smoothly. That’s why they must have access to a platform that helps them keep up with ever-evolving guidelines and keep them audit-ready at all times.
FieldWorker is designed by experts in technology and care delivery, who have ensured that there’s a place for all of your records on the platform. Whether you need EVV records, timesheets, or overviews of billing and expenses, everything is kept in one accessible place.
With the number of tasks to do, it’s no wonder updating records can take a back seat. That’s why FieldWorker makes it quick and painless. From updating case notes via dictation to one-touch check-in and out for activity tracking and EVV compliance, keeping up to date is no longer a challenge.
With up-to-date call logs, EVV records, timesheets, billing info, activity reports, case notes, client data, and more, you can be confident that you’ll be ready for an audit at any time without the stress!
Support Coordination Agencies
The Rationale for Support Coordination Agency Evaluation
Ensure high-quality services are being provided to individuals served.
Ensure that SCAs meet Division waiver (manual) requirements.
Ensure that SCAs are meeting the requirements necessary for claiming/avoiding Medicaid fraud.
Centers for Medicare and Medicaid Services (CMS) reserves the right to audit waiver programs.
Recent audit findings
In 23% of audited cases, central registry checks were not completed
In 36% of cases, DDD-required training was missing
In 21% of cases, no updates were being made to PCPT
In 10% of the cases, quarterly MMT was missing
In 12% of cases, annual home visit documentation was missing
An SCA must provide services in at least one county and for a minimum of 60 individuals. While a deadline is not yet established, any Support Coordination Agency that serves below 60 individuals is directed to take steps to meet that minimum requirement.
Ensuring compliance
Services billed matched with a qualifying task in the system
Services billed are matched and documented with qualified staff and the correct date of service.
No duplicate billing, no missing records
Ensuring that a signature is captured, where needed
No missing documentation
Security Audit Checklist
This checklist is designed to help your agency maintain high security standards. We recommend performing this audit quarterly to ensure that sensitive financial and organizational data is only accessible to those who strictly require it for their current job duties.
📋 Part 1: Employee Roster Cleanup
Before diving into specific permissions, ensure your active roster is accurate.
[ ] Verify Active Status: Go to the Employee Settings list. Filter by Status: Active. Are there any former employees or contractors still listed as active?
[ ] Process Terminations: For any former staff still marked "Active," click the Edit icon and switch their status to Terminated. This immediately revokes their login credentials.
[ ] Audit "Temp" Roles: Review users assigned the "Temp" or "Engineering" designations. If their project has concluded, deactivate or restrict their access.
🔍 Part 2: High-Level Access Review
Open the Set Permissions modal for your Admin and Manager roles. Pay close attention to these "High-Risk" categories:
1. Settings & Infrastructure
[ ] Settings Tabs: Ensure only the Primary Admin has access to "Advanced," "Subscription," and "Agency" tabs. Access to these allows a user to change billing rates and company-wide workflows.
[ ] Billing Tab: Access to "Claims" and "Remittances" should be restricted to your specialized billing or accounting staff.
2. Financial & Sensitive Reporting
[ ] Company Reports: Access to the Payroll Report should be extremely limited, as it contains sensitive salary data for the entire agency.
[ ] Billing Reports: Check who can view the Billing Transaction and Claim Collection reports.
3. Organizational Control
[ ] Resource Functionalities: Specifically check who has the Invite Employees permission. This should be restricted to HR or Senior Management to prevent unauthorized account creation.
[ ] Scheduler: Verify who can schedule sessions for other employees. This is a powerful permission that should be reserved for those in dispatch or management roles.
🛠️ Part 3: Action Items for Identified Risks
If you find an employee with excessive access, follow these steps:
Immediate Revision: Uncheck the unnecessary boxes in their Permissions Modal.
Save: Click the blue [SAVE] button at the top right of the modal.
Communication: Inform the employee that their profile has been updated to align with current security protocols.
Verification: Ask the employee to refresh their dashboard to confirm the restricted tabs are no longer visible.
The "Admin" Trap: Avoid the temptation to mark every manager as a full "Admin." It is much safer to give a Manager specific access to the Employee Tab and Billing Reports rather than granting full Advanced Settings access.
Exclusions Program
OIG has the authority to exclude individuals and entities from federally funded health care programs.
This webpage provides information about OIG's exclusion authority and activities. OIG has the authority to exclude individuals and entities from federally funded healthcare programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud. Those who are excluded can receive no payment from Federal health care programs for any items or services they furnish, order, or prescribe. This includes those that provide health benefits funded directly or indirectly by the United States (other than the Federal Employees Health Benefits Plan).
OIG maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (CMP). To avoid CMP liability, healthcare entities should routinely check the list to ensure that new hires and current employees are not on it.
Debarment Report
Comparison Logic: Employee First Name, Last Name, and Employee ZIP
NJ Treasury
Agency debarment, suspension, and disqualification actions taken pursuant to Executive Orders #34 (1976) and #189 (1988).
NJ Consolidated Debarment Report
Comparison Logic: Employee First Name, Last Name, and Employee ZIP
For support coordination agencies, Fieldworker allows you to generate a debarment report on demand.
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